Robert J. Fleck
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View article: 1011 Comparison of MRI-based Dynamic 4D Airway Measurements and DISE Results in Pediatric Patients with Persistent OSA
1011 Comparison of MRI-based Dynamic 4D Airway Measurements and DISE Results in Pediatric Patients with Persistent OSA Open
Introduction Obstructive sleep apnea (OSA) is persistent in approximately 40% of pediatric patients following adenotonsillectomy (AT), often leading to secondary surgical interventions. Magnetic resonance imaging (MRI) and drug induced sle…
View article: 0452 Quantification of How Hypoglossal Nerve Stimulation Affects Upper Airway Neuromuscular Control Using Computational Airflow Modeling
0452 Quantification of How Hypoglossal Nerve Stimulation Affects Upper Airway Neuromuscular Control Using Computational Airflow Modeling Open
Introduction Hypoglossal nerve stimulation (HGNS) has emerged as an alternative treatment for obstructive sleep apnea (OSA) patients in patients who cannot tolerate continuous positive airway pressure therapy. While clinical trials of HGNS…
View article: Effects of Hypoglossal Nerve Stimulation on Upper Airway Structure and Function Using Moving Wall Computational Fluid Dynamics Simulations: A Pilot Study
Effects of Hypoglossal Nerve Stimulation on Upper Airway Structure and Function Using Moving Wall Computational Fluid Dynamics Simulations: A Pilot Study Open
Hypoglossal nerve stimulation (HGNS) is an innovative alternative treatment option for obstructive sleep apnoea (OSA) in patients unable to tolerate continuous positive airway pressure. However, the success rate of HGNS is variable, but th…
View article: Clinical Outcomes Through Two Years for Infants With Bronchopulmonary Dysplasia and Tracheomalacia
Clinical Outcomes Through Two Years for Infants With Bronchopulmonary Dysplasia and Tracheomalacia Open
Background Tracheomalacia (TM) is common in infants with bronchopulmonary dysplasia (BPD) and associated with respiratory morbidity. Assessment of TM was historically via bronchoscopy, but recent studies demonstrate that ultrashort echo‐ti…
View article: Evaluation of Pediatric Posterior Glottic Diastasis Using Dynamic Voice Computed Tomography
Evaluation of Pediatric Posterior Glottic Diastasis Using Dynamic Voice Computed Tomography Open
Objectives Posterior glottic diastasis (PGD) is an underappreciated etiology of dysphonia in patients with prior airway reconstruction or prolonged intubation. In endoscopic posterior cricoid reduction (ePCR), cricoid is removed to minimiz…
View article: Pectus excavatum: the effect of tricuspid valve compression on cardiac function
Pectus excavatum: the effect of tricuspid valve compression on cardiac function Open
Background Pectus excavatum (PE) is a common congenital chest wall deformity with various associated health concerns, including psychosocial impacts, academic challenges, and potential cardiopulmonary effects. Objective This study aimed to…
View article: Assessing Residual Gastric Fluid Volume after Administering Diluted Oral Contrast until One Hour Prior to Anesthesia in Children: An Observational Cohort Study
Assessing Residual Gastric Fluid Volume after Administering Diluted Oral Contrast until One Hour Prior to Anesthesia in Children: An Observational Cohort Study Open
Background: Gastric fluid volume has been used as a surrogate marker for pulmonary aspiration risk in studies evaluating fasting protocol safety. This study measured residual gastric fluid volume in children using a protocol in which dilut…
View article: The interaction between neuromuscular forces, aerodynamic forces, and anatomical motion in the upper airway predicts the severity of pediatric OSA
The interaction between neuromuscular forces, aerodynamic forces, and anatomical motion in the upper airway predicts the severity of pediatric OSA Open
This is the first study that combines cine MRI and computational fluid dynamics with in vivo synchronous respiratory flow measurement to quantify the interaction between airway neuromuscular forces, aerodynamic forces, and airway anatomy n…
View article: Characterization of Auricular Growth within the Pediatric Population Using Computed Tomography Scan Measurements
Characterization of Auricular Growth within the Pediatric Population Using Computed Tomography Scan Measurements Open
Background: In patients with microtia, auricular reconstruction is ideally performed promptly to prevent impaired socialization during formative childhood years. The earliest viable age for reconstruction is widely accepted from 7–10 years…
View article: Phase-Contrast Magnetic Resonance Imaging of Inhaled Xenon Reveals the Relationship between Airflow and Obstruction in Obstructive Sleep Apnea
Phase-Contrast Magnetic Resonance Imaging of Inhaled Xenon Reveals the Relationship between Airflow and Obstruction in Obstructive Sleep Apnea Open
"Phase-Contrast Magnetic Resonance Imaging of Inhaled Xenon Reveals the Relationship between Airflow and Obstruction in Obstructive Sleep Apnea." American Journal of Respiratory and Critical Care Medicine, 208(3), pp. e5–e6
View article: Predicting tracheal work of breathing in neonates based on radiological and pulmonary measurements
Predicting tracheal work of breathing in neonates based on radiological and pulmonary measurements Open
The work of breathing due to resistance in the trachea is an important metric for quantifying the effect of tracheal abnormalities such as tracheomalacia, but currently requires complex dynamic imaging and computational fluid dynamics simu…
View article: Gas accretion onto galaxies and Kelvin-Helmholtz turbulence
Gas accretion onto galaxies and Kelvin-Helmholtz turbulence Open
Continued star formation over the lifetime of a galaxy suggests that low metalicity gas is steadily flowing in from the circumgalactic medium. Also, cosmological simulations of large-scale structure formation imply that gas is accreted ont…
View article: Virtual Bronchoscopy of Neonatal Airway Malacia via High-Resolution, Respiratory-gated Magnetic Resonance Imaging
Virtual Bronchoscopy of Neonatal Airway Malacia via High-Resolution, Respiratory-gated Magnetic Resonance Imaging Open
"Virtual Bronchoscopy of Neonatal Airway Malacia via High-Resolution, Respiratory-gated Magnetic Resonance Imaging." American Journal of Respiratory and Critical Care Medicine, 206(5), pp. e42–e43
View article: Sleep Endoscopy and Cine Magnetic Resonance Imaging Evaluation of Children With Persistent Obstructive Sleep Apnea
Sleep Endoscopy and Cine Magnetic Resonance Imaging Evaluation of Children With Persistent Obstructive Sleep Apnea Open
Objective To compare findings of same‐day cine magnetic resonance imaging (MRI) and drug‐induced sleep endoscopy (DISE) and examine how each technique uniquely contributes to the evaluation of persistent obstructive sleep apnea following a…
View article: Cover Image, Volume 57, Number 4, April 2022
Cover Image, Volume 57, Number 4, April 2022 Open
Back Cover Caption: The cover image is based on the Original Article Tracheostomy prediction model in neonatal bronchopulmonary dysplasia via lung and airway MRI by Stephanie A. Adaikalam et al., https://doi.org/10.1002/ppul.25905. Image C…
View article: Tracheostomy prediction model in neonatal bronchopulmonary dysplasia via lung and airway MRI
Tracheostomy prediction model in neonatal bronchopulmonary dysplasia via lung and airway MRI Open
Rationale Clinical management of neonatal bronchopulmonary dysplasia (BPD) is often imprecise and can vary widely between different institutions and providers, due to limited objective measurements of disease pathology severity. There is c…
View article: Predicting critical closing pressure in children with obstructive sleep apnea using fluid-structure interaction
Predicting critical closing pressure in children with obstructive sleep apnea using fluid-structure interaction Open
We present a noninvasive method for estimating critical closing pressure (Pcrit) using fluid-structure interaction (FSI) simulations and magnetic resonance imaging (MRI) scans in patients with obstructive sleep apnea (OSA). We used patient…
View article: Neonates with Tracheomalacia Generate Auto-PEEP via Glottis Closure Measured by MRI-Based Computational Fluid Dynamics
Neonates with Tracheomalacia Generate Auto-PEEP via Glottis Closure Measured by MRI-Based Computational Fluid Dynamics Open
Rationale: Newborns diagnosed with tracheomalacia (TM) have breathing difficulties due to airway collapse.Studies in adults with obstructive lung disease have shown evidence of self-generated positive end-expiratory pressure (auto-PEEP) by…
View article: Ventilatory limitations are not associated with dyspnea on exertion or reduced aerobic fitness in pectus excavatum
Ventilatory limitations are not associated with dyspnea on exertion or reduced aerobic fitness in pectus excavatum Open
Pulmonary defects are reported in pectus excavatum but the physiological impact on exercise capacity is unclear. To test the hypothesis that pectus deformities are associated with a pulmonary impairment during exercise we performed a retro…
View article: Quantitative Evaluation of Subglottic Stenosis Using Ultrashort Echo Time <scp>MRI</scp> in a Rabbit Model
Quantitative Evaluation of Subglottic Stenosis Using Ultrashort Echo Time <span>MRI</span> in a Rabbit Model Open
Objective/Hypothesis To assess the ability of ultra‐short echo time (UTE)‐MRI to detect subglottic stenosis (SGS) and evaluate response to balloon dilation. To correlate measurements from UTE‐MRI with endotracheal‐tube (ETT)‐sizing and to …